|
HC URETERAL DILITATION CATH
|
Facility
|
OP
|
$349.74
|
|
|
Service Code
|
HCPCS C1758
|
| Hospital Charge Code |
27200077
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$83.06 |
| Max. Negotiated Rate |
$314.77 |
| Rate for Payer: Aetna Commercial |
$297.28
|
| Rate for Payer: Aetna Medicare |
$90.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.29
|
| Rate for Payer: BCBS Complete |
$139.90
|
| Rate for Payer: BCBS MAPPO |
$87.44
|
| Rate for Payer: BCBS Trust/PPO |
$271.92
|
| Rate for Payer: BCN Commercial |
$271.92
|
| Rate for Payer: BCN Medicare Advantage |
$87.44
|
| Rate for Payer: Cash Price |
$279.79
|
| Rate for Payer: Cofinity Commercial |
$300.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.44
|
| Rate for Payer: Healthscope Commercial |
$314.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.28
|
| Rate for Payer: PACE Senior Care Partners |
$83.06
|
| Rate for Payer: PACE SWMI |
$87.44
|
| Rate for Payer: PHP Commercial |
$297.28
|
| Rate for Payer: PHP Medicare Advantage |
$87.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.27
|
| Rate for Payer: Priority Health Medicare |
$87.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.31
|
| Rate for Payer: Railroad Medicare Medicare |
$87.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.77
|
| Rate for Payer: UHC Core |
$292.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.44
|
| Rate for Payer: UHC Medicare Advantage |
$90.06
|
| Rate for Payer: VA VA |
$87.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.30
|
|
|
HC URETERAL DILITATION CATH
|
Facility
|
IP
|
$349.74
|
|
|
Service Code
|
HCPCS C1758
|
| Hospital Charge Code |
27200077
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$213.31 |
| Max. Negotiated Rate |
$314.77 |
| Rate for Payer: Aetna Commercial |
$297.28
|
| Rate for Payer: BCBS Trust/PPO |
$270.28
|
| Rate for Payer: BCN Commercial |
$270.28
|
| Rate for Payer: Cash Price |
$279.79
|
| Rate for Payer: Cofinity Commercial |
$300.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.79
|
| Rate for Payer: Healthscope Commercial |
$314.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.28
|
| Rate for Payer: PHP Commercial |
$297.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.77
|
| Rate for Payer: UHC Core |
$292.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.30
|
|
|
HC URIC ACID OTHER SOURCE
|
Facility
|
IP
|
$37.90
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
30100453
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.12 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: BCBS Trust/PPO |
$29.29
|
| Rate for Payer: BCN Commercial |
$29.29
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
| Rate for Payer: UHC Core |
$31.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC URIC ACID OTHER SOURCE
|
Facility
|
OP
|
$37.90
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
30100453
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: Aetna Medicare |
$9.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.84
|
| Rate for Payer: BCBS Complete |
$3.94
|
| Rate for Payer: BCBS MAPPO |
$9.48
|
| Rate for Payer: BCBS Trust/PPO |
$29.47
|
| Rate for Payer: BCN Commercial |
$29.47
|
| Rate for Payer: BCN Medicare Advantage |
$9.48
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.48
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Mclaren Medicaid |
$3.75
|
| Rate for Payer: Meridian Medicaid |
$3.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PACE Senior Care Partners |
$9.00
|
| Rate for Payer: PACE SWMI |
$9.48
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: PHP Medicare Advantage |
$9.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
| Rate for Payer: Priority Health Medicare |
$9.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
| Rate for Payer: Railroad Medicare Medicare |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
| Rate for Payer: UHC Core |
$31.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.48
|
| Rate for Payer: UHC Medicare Advantage |
$9.76
|
| Rate for Payer: VA VA |
$9.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC URIC ACID SERUM
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
30100452
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC URIC ACID SERUM
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
30100452
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.34 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$3.50
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$3.34
|
| Rate for Payer: Meridian Medicaid |
$3.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC URINALYSIS
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 81001
|
| Hospital Charge Code |
30700001
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC URINALYSIS
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 81001
|
| Hospital Charge Code |
30700001
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$2.46
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$2.34
|
| Rate for Payer: Meridian Medicaid |
$2.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC URINALYSIS, DIPSTICK ONLY
|
Facility
|
IP
|
$20.80
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
30700002
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$12.69 |
| Max. Negotiated Rate |
$18.72 |
| Rate for Payer: Aetna Commercial |
$17.68
|
| Rate for Payer: BCBS Trust/PPO |
$16.07
|
| Rate for Payer: BCN Commercial |
$16.07
|
| Rate for Payer: Cash Price |
$16.64
|
| Rate for Payer: Cofinity Commercial |
$17.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.64
|
| Rate for Payer: Healthscope Commercial |
$18.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.68
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.30
|
| Rate for Payer: UHC Core |
$17.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.60
|
|
|
HC URINALYSIS, DIPSTICK ONLY
|
Facility
|
OP
|
$20.80
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
30700002
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.66 |
| Max. Negotiated Rate |
$18.72 |
| Rate for Payer: Aetna Commercial |
$17.68
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$1.74
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$16.17
|
| Rate for Payer: BCN Commercial |
$16.17
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.64
|
| Rate for Payer: Cash Price |
$16.64
|
| Rate for Payer: Cofinity Commercial |
$17.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.60
|
| Rate for Payer: Mclaren Medicaid |
$1.66
|
| Rate for Payer: Meridian Medicaid |
$1.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.68
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.69
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.30
|
| Rate for Payer: UHC Core |
$17.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.36
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.60
|
|
|
HC URINALYSIS, MICROSCOPIC ONLY
|
Facility
|
OP
|
$37.90
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700004
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: Aetna Medicare |
$9.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.84
|
| Rate for Payer: BCBS Complete |
$2.36
|
| Rate for Payer: BCBS MAPPO |
$9.48
|
| Rate for Payer: BCBS Trust/PPO |
$29.47
|
| Rate for Payer: BCN Commercial |
$29.47
|
| Rate for Payer: BCN Medicare Advantage |
$9.48
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.48
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Mclaren Medicaid |
$2.25
|
| Rate for Payer: Meridian Medicaid |
$2.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PACE Senior Care Partners |
$9.00
|
| Rate for Payer: PACE SWMI |
$9.48
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: PHP Medicare Advantage |
$9.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
| Rate for Payer: Priority Health Medicare |
$9.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
| Rate for Payer: Railroad Medicare Medicare |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
| Rate for Payer: UHC Core |
$31.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.48
|
| Rate for Payer: UHC Medicare Advantage |
$9.76
|
| Rate for Payer: VA VA |
$9.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC URINALYSIS, MICROSCOPIC ONLY
|
Facility
|
IP
|
$37.90
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700004
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$23.12 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: BCBS Trust/PPO |
$29.29
|
| Rate for Payer: BCN Commercial |
$29.29
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
| Rate for Payer: UHC Core |
$31.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC URINARY 1 PIECE POUCH
|
Facility
|
OP
|
$13.78
|
|
| Hospital Charge Code |
27000167
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$12.40 |
| Rate for Payer: Aetna Commercial |
$11.71
|
| Rate for Payer: Aetna Medicare |
$3.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.31
|
| Rate for Payer: BCBS Complete |
$5.51
|
| Rate for Payer: BCBS MAPPO |
$3.44
|
| Rate for Payer: BCBS Trust/PPO |
$10.71
|
| Rate for Payer: BCN Commercial |
$10.71
|
| Rate for Payer: BCN Medicare Advantage |
$3.44
|
| Rate for Payer: Cash Price |
$11.02
|
| Rate for Payer: Cofinity Commercial |
$11.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.44
|
| Rate for Payer: Healthscope Commercial |
$12.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.71
|
| Rate for Payer: PACE Senior Care Partners |
$3.27
|
| Rate for Payer: PACE SWMI |
$3.44
|
| Rate for Payer: PHP Commercial |
$11.71
|
| Rate for Payer: PHP Medicare Advantage |
$3.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.99
|
| Rate for Payer: Priority Health Medicare |
$3.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.40
|
| Rate for Payer: Railroad Medicare Medicare |
$3.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.13
|
| Rate for Payer: UHC Core |
$11.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.44
|
| Rate for Payer: UHC Medicare Advantage |
$3.55
|
| Rate for Payer: VA VA |
$3.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.34
|
|
|
HC URINARY 1 PIECE POUCH
|
Facility
|
IP
|
$13.78
|
|
| Hospital Charge Code |
27000167
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$12.40 |
| Rate for Payer: Aetna Commercial |
$11.71
|
| Rate for Payer: BCBS Trust/PPO |
$10.65
|
| Rate for Payer: BCN Commercial |
$10.65
|
| Rate for Payer: Cash Price |
$11.02
|
| Rate for Payer: Cofinity Commercial |
$11.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.02
|
| Rate for Payer: Healthscope Commercial |
$12.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.71
|
| Rate for Payer: PHP Commercial |
$11.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.13
|
| Rate for Payer: UHC Core |
$11.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.34
|
|
|
HC URINE ALCOHOL SCRN
|
Facility
|
IP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000122
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.53 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: BCBS Trust/PPO |
$71.62
|
| Rate for Payer: BCN Commercial |
$71.62
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC URINE ALCOHOL SCRN
|
Facility
|
OP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000122
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.01 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: Aetna Medicare |
$24.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.96
|
| Rate for Payer: BCBS Complete |
$48.15
|
| Rate for Payer: BCBS MAPPO |
$23.17
|
| Rate for Payer: BCBS Trust/PPO |
$72.06
|
| Rate for Payer: BCN Commercial |
$72.06
|
| Rate for Payer: BCN Medicare Advantage |
$23.17
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.17
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$48.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PACE Senior Care Partners |
$22.01
|
| Rate for Payer: PACE SWMI |
$23.17
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: PHP Medicare Advantage |
$23.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Medicare |
$23.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: Railroad Medicare Medicare |
$23.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.17
|
| Rate for Payer: UHC Medicare Advantage |
$23.87
|
| Rate for Payer: VA VA |
$23.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC URINE AMPHETAMINE CONFIRM
|
Facility
|
IP
|
$31.00
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30100569
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.91 |
| Max. Negotiated Rate |
$27.90 |
| Rate for Payer: Aetna Commercial |
$26.35
|
| Rate for Payer: BCBS Trust/PPO |
$23.96
|
| Rate for Payer: BCN Commercial |
$23.96
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$26.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.80
|
| Rate for Payer: Healthscope Commercial |
$27.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.35
|
| Rate for Payer: PHP Commercial |
$26.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.28
|
| Rate for Payer: UHC Core |
$25.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.25
|
|
|
HC URINE AMPHETAMINE CONFIRM
|
Facility
|
OP
|
$31.00
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30100569
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$27.90 |
| Rate for Payer: Aetna Commercial |
$26.35
|
| Rate for Payer: Aetna Medicare |
$8.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.69
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$7.75
|
| Rate for Payer: BCBS Trust/PPO |
$24.10
|
| Rate for Payer: BCN Commercial |
$24.10
|
| Rate for Payer: BCN Medicare Advantage |
$7.75
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$26.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.75
|
| Rate for Payer: Healthscope Commercial |
$27.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.35
|
| Rate for Payer: PACE Senior Care Partners |
$7.36
|
| Rate for Payer: PACE SWMI |
$7.75
|
| Rate for Payer: PHP Commercial |
$26.35
|
| Rate for Payer: PHP Medicare Advantage |
$7.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.97
|
| Rate for Payer: Priority Health Medicare |
$7.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.91
|
| Rate for Payer: Railroad Medicare Medicare |
$7.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.28
|
| Rate for Payer: UHC Core |
$25.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.75
|
| Rate for Payer: UHC Medicare Advantage |
$7.98
|
| Rate for Payer: VA VA |
$7.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.25
|
|
|
HC URINE CULTURE
|
Facility
|
IP
|
$39.29
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
30600080
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.96 |
| Max. Negotiated Rate |
$35.36 |
| Rate for Payer: Aetna Commercial |
$33.40
|
| Rate for Payer: BCBS Trust/PPO |
$30.36
|
| Rate for Payer: BCN Commercial |
$30.36
|
| Rate for Payer: Cash Price |
$31.43
|
| Rate for Payer: Cofinity Commercial |
$33.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.43
|
| Rate for Payer: Healthscope Commercial |
$35.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.40
|
| Rate for Payer: PHP Commercial |
$33.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.58
|
| Rate for Payer: UHC Core |
$32.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.47
|
|
|
HC URINE CULTURE
|
Facility
|
OP
|
$39.29
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
30600080
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$35.36 |
| Rate for Payer: Aetna Commercial |
$33.40
|
| Rate for Payer: Aetna Medicare |
$10.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.28
|
| Rate for Payer: BCBS Complete |
$6.25
|
| Rate for Payer: BCBS MAPPO |
$9.82
|
| Rate for Payer: BCBS Trust/PPO |
$30.55
|
| Rate for Payer: BCN Commercial |
$30.55
|
| Rate for Payer: BCN Medicare Advantage |
$9.82
|
| Rate for Payer: Cash Price |
$31.43
|
| Rate for Payer: Cash Price |
$31.43
|
| Rate for Payer: Cofinity Commercial |
$33.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.82
|
| Rate for Payer: Healthscope Commercial |
$35.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.47
|
| Rate for Payer: Mclaren Medicaid |
$5.96
|
| Rate for Payer: Meridian Medicaid |
$6.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.40
|
| Rate for Payer: PACE Senior Care Partners |
$9.33
|
| Rate for Payer: PACE SWMI |
$9.82
|
| Rate for Payer: PHP Commercial |
$33.40
|
| Rate for Payer: PHP Medicare Advantage |
$9.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.18
|
| Rate for Payer: Priority Health Medicare |
$9.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.96
|
| Rate for Payer: Railroad Medicare Medicare |
$9.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.58
|
| Rate for Payer: UHC Core |
$32.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.82
|
| Rate for Payer: UHC Medicare Advantage |
$10.12
|
| Rate for Payer: VA VA |
$9.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.47
|
|
|
HC URINE DRUG SCREEN 80306
|
Facility
|
IP
|
$24.77
|
|
|
Service Code
|
CPT 80306
|
| Hospital Charge Code |
30000145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.11 |
| Max. Negotiated Rate |
$22.29 |
| Rate for Payer: Aetna Commercial |
$21.05
|
| Rate for Payer: BCBS Trust/PPO |
$19.14
|
| Rate for Payer: BCN Commercial |
$19.14
|
| Rate for Payer: Cash Price |
$19.82
|
| Rate for Payer: Cofinity Commercial |
$21.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.82
|
| Rate for Payer: Healthscope Commercial |
$22.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.05
|
| Rate for Payer: PHP Commercial |
$21.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.80
|
| Rate for Payer: UHC Core |
$20.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.58
|
|
|
HC URINE DRUG SCREEN 80306
|
Facility
|
OP
|
$24.77
|
|
|
Service Code
|
CPT 80306
|
| Hospital Charge Code |
30000145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.88 |
| Max. Negotiated Rate |
$22.29 |
| Rate for Payer: Aetna Commercial |
$21.05
|
| Rate for Payer: Aetna Medicare |
$6.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.74
|
| Rate for Payer: BCBS Complete |
$13.28
|
| Rate for Payer: BCBS MAPPO |
$6.19
|
| Rate for Payer: BCBS Trust/PPO |
$19.26
|
| Rate for Payer: BCN Commercial |
$19.26
|
| Rate for Payer: BCN Medicare Advantage |
$6.19
|
| Rate for Payer: Cash Price |
$19.82
|
| Rate for Payer: Cash Price |
$19.82
|
| Rate for Payer: Cofinity Commercial |
$21.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.19
|
| Rate for Payer: Healthscope Commercial |
$22.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.58
|
| Rate for Payer: Mclaren Medicaid |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$13.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.05
|
| Rate for Payer: PACE Senior Care Partners |
$5.88
|
| Rate for Payer: PACE SWMI |
$6.19
|
| Rate for Payer: PHP Commercial |
$21.05
|
| Rate for Payer: PHP Medicare Advantage |
$6.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.55
|
| Rate for Payer: Priority Health Medicare |
$6.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.11
|
| Rate for Payer: Railroad Medicare Medicare |
$6.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.80
|
| Rate for Payer: UHC Core |
$20.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.19
|
| Rate for Payer: UHC Medicare Advantage |
$6.38
|
| Rate for Payer: VA VA |
$6.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.58
|
|
|
HC URINE PHENCYCLIDINE
|
Facility
|
IP
|
$62.00
|
|
|
Service Code
|
CPT 83992
|
| Hospital Charge Code |
30100386
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.81 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Aetna Commercial |
$52.70
|
| Rate for Payer: BCBS Trust/PPO |
$47.91
|
| Rate for Payer: BCN Commercial |
$47.91
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$53.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.60
|
| Rate for Payer: Healthscope Commercial |
$55.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.70
|
| Rate for Payer: PHP Commercial |
$52.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.56
|
| Rate for Payer: UHC Core |
$51.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.50
|
|
|
HC URINE PHENCYCLIDINE
|
Facility
|
OP
|
$62.00
|
|
|
Service Code
|
CPT 83992
|
| Hospital Charge Code |
30100386
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.72 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Aetna Commercial |
$52.70
|
| Rate for Payer: Aetna Medicare |
$16.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.38
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$48.20
|
| Rate for Payer: BCN Commercial |
$48.20
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$53.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$55.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.70
|
| Rate for Payer: PACE Senior Care Partners |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Commercial |
$52.70
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.94
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.81
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.56
|
| Rate for Payer: UHC Core |
$51.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.50
|
| Rate for Payer: UHC Medicare Advantage |
$15.96
|
| Rate for Payer: VA VA |
$15.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.50
|
|
|
HC URINE PREGNANCY TEST
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30700005
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$6.67
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCCCP Commercial |
$8.61
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$6.35
|
| Rate for Payer: Meridian Medicaid |
$6.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
